The present invention is an improvement of the U.S. Pat. No. 6,446,288, and the present invention includes additional components and specifically designs for obese patients. According to the National Center for Health, obesity is increasing greatly in the United States. 63% of Americans are overweight with a BMI (body mass index) over 25.0; 31% are obese with a BMI of over 30.0; 3.8 million people have a body weight over 300 pounds. As the population of obese people increase, the amount of surgeries related to the obese population are also increasing. According to the text book of Clinical Anesthesia published in 2001, the obese patient may need further positioning to move the mass of the chest away from the plane across which the laryngoscope handle will sweep as it is manipulated into the mouth. This may require placing a wedge-shaped lift (e.g., blankets, pillows) under the scapula, shoulders, and nape of neck, raising the head and the neck above the thorax and providing a grade to allow gravity to take the mass away from the airway. Positioning the obese patient with a roll under the scapulas and an occipital rest and asking the obese patient to fully extend the atlanto-occipital joint before induction may facilitate awake or conventional laryngoscopy and intubation as presented in Miller's Anesthesia published in 2004. The present invention effectively raises the obese patient's head and neck above the thorax and maintains the patient's head and neck in a stable extended position, which is also known as the sniff position. The present invention facilitates mask ventilation, direct laryngoscopy, insertion of laryngeal mask and fiberoptic bronchoscope-aided intubation.
Accordingly, the present invention is directed to an apparatus for facilitating tracheal intubation on an obese patient, comprising a base section (1) comprising a bottom portion having a bottom surface (15) and an upper portion (12). The upper portion (12) comprises an inclined surface (124) for receiving an upper back of a patient. The base section (1) further comprises a lower, front end having a front surface (123) and an upper, rear end (13) having a vertical rear wall. The lower, front end has a first height and the upper, rear end (13) has a second height that is greater than the first height so as to provide the incline of the inclined surface (124). The base section (1) further comprise a pair of sidewalls (121, 122) that are parallel to each other and perpendicular to the vertical rear wall of the upper, rear end (13). The upper portion (12) has an upper, perimetrical boundary at the upper, rear end (13) that extends between the pair of sidewalls (121, 122). The upper portion (12) further comprises an indentation (16) in the inclined surface (124) which bisects the upper, perimetrical boundary and is centrally located between the pair of sidewalls (121, 122). The indentation (16) is sized and shaped to receive the back portion of a patient's neck. The apparatus further comprises a head section (11) that is attached to the vertical rear wall of the upper, rear end (13). The head section (11) comprises an upper end that is adjacent to the perimetrical boundary of the upper portion (12) and which has a third height that is equal to the second height of the upper, rear end (13) of base section (1). The head section (11) further comprises a lower end that has a fourth height that is less than the third height. The fourth height of the lower end of the head section (11) is greater than the first height of the lower, front end of the base section (1). The head section (11) further comprises a pair of sidewalls (111, 112) and a rear wall (113). The rear wall (113) and the pair of sidewalls (111, 112) are vertically oriented and sidewalls (111, 112) are substantially perpendicular to the rear wall (113). The head section (11) further comprises a downwardly sloping contour (114) that extends between the upper end of the head section (11) and the lower end of the head section (11). The indentation (16) extends beyond the perimetrical boundary of upper portion (12) of base section (1) and the upper end of the head section (11) such that the indentation (16) is contiguous with the downwardly sloping contour (114). The head section (11) further comprises a cavity (115) that is centrally located in the downwardly sloping contour (114). The cavity (115) is substantially aligned with indentation (16) and has a first predetermined diameter that allows the occiput of a patient's head to be positioned within the cavity (115). The base section (1) has a first width measured from sidewall to sidewall and the head section (11) has a second width measured from the sidewall to the sidewall. The first width is greater than the second width. The apparatus further comprises a pad member (2) that is removably and adjustably positioned upon the downwardly sloping contour (114) of the head section (11). The pad member (2) comprises a top side (21), a pair of sidewalls (22, 23) and a curved bottom side (25) for contacting the downwardly sloping contour (114). The curved bottom side (25) has a curvature that corresponds to the curvature of the downwardly sloping contour (114). The pad member (2) further comprises a centrally located cavity (26) that is sized to receive the occiput of a patient's head. The position of the pad member (2) upon the downwardly sloping contour (114) may be adjusted to different positions so that the top side (21) of the pad member (2) is angulated to different desired degrees of angulation. The apparatus further comprises a pair of arm rests (3, 4) that are separate from the base section (1) and head section (11) such that the arm rests (3, 4) may be moved to different angular positions with respect to the base section (1) and head section (11). Each arm rest (3, 4) is located on a corresponding side of the base section (1). Each arm rest (3, 4) comprises a relatively shallow arm channel (41), a first pair of sidewalls (42), a second pair of sidewalls (43), a top surface (44), a bottom surface (45), a first end having a fifth height and a second end that has a sixth height wherein the sixth height is less than the fifth height so as to provide an incline in each arm rest (3, 4). Each arm channel (41) is centrally positioned in top surface (44) between the second pair of sidewalls (43).